I

★

106TH CONGRESS

2D SESSION S. 1488

IN THE HOUSE OF REPRESENTATIVES

JANUARY 27, 2000

Referred to the Committee on Commerce

AN ACT

To amend the Public Health Service Act to provide for

recommendations of the Secretary of Health and Human

Services regarding the placement of automatic external

defibrillators in Federal buildings in order to improve

survival rates of individuals who experience cardiac arrest

in such buildings, and to establish protections from civil

liability arising from the emergency use of the devices.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Cardiac Arrest Sur5 vival Act of 1999’’.
2

S 1488 RFH1S

1 SEC. 2. FINDINGS.

2 The Congress finds as follows:

3 (1) Each year more than 250,000 adults suffer

4 cardiac arrest, usually away from a hospital. More

5 than 95 percent of them will die, in many cases be6 cause cardiopulmonary resuscitation (‘‘CPR’’),

7 defibrillation, and advanced life support are provided

8 too late to reverse the cardiac arrest. These cardiac

9 arrests occur primarily from occult underlying heart

10 disease and from drowning, allergic or sensitivity re11 actions, or electrical shocks.

12 (2) Every minute that passes before returning

13 the heart to a normal rhythm after a cardiac arrest

14 causes the chance of survival to fall by 10 percent.

15 (3) In communities where strong public access

16 to defibrillation programs have been implemented,

17 survival from cardiac arrest has improved by as

18 much as 20 percent.

19 (4) Survival from cardiac arrest requires suc20 cessful early implementation of a chain of events,

21 known as the chain of survival, which must be initi22 ated as soon as the person sustains a cardiac arrest

23 and must continue until the person arrives at the

24 hospital.

25 (5) The chain of survival is the medical stand26 ard of care for treatment of cardiac arrest.
3

S 1488 RFH1S

1 (6) A successful chain of survival requires the

2 first person on the scene to take rapid and simple

3 initial steps to care for the patient and to assure

4 that the patient promptly enters the emergency med5 ical services system. These steps include—

6 (A) recognizing an emergency and acti7 vating the emergency medical services system;

8 (B) beginning CPR; and

9 (C) using an automated external

10 defibrillator (‘‘AED’’) if one is available at the

11 scene.

12 (7) The first persons at the scene of an arrest

13 are typically lay persons who are friends or family

14 of the victim, fire services, public safety personnel,

15 basic life support emergency medical services pro16 viders, teachers, coaches and supervisors of sports or

17 other extracurricular activities, providers of day

18 care, school bus drivers, lifeguards, attendants at

19 public gatherings, coworkers, and other leaders with20 in the community.

21 (8) The Federal Government should facilitate

22 programs for the placement of AEDs in public build23 ings, including provisions regarding the training of

24 personnel in CPR and AED use, integration with
4

S 1488 RFH1S

1 the emergency medical services system, and mainte2 nance of the devices.

3 SEC. 3. RECOMMENDATIONS OF SECRETARY OF HEALTH

4 AND HUMAN SERVICES REGARDING PLACE5 MENT OF AUTOMATIC EXTERNAL

6 DEFIBRILLATORS IN BUILDINGS.

7 Part B of title II of the Public Health Service Act

8 (42 U.S.C. 238 et seq.) is amended by adding at the end

9 the following section:

10 ‘‘RECOMMENDATIONS REGARDING PLACEMENT OF

11 AUTOMATED EXTERNAL DEFIBRILLATORS IN BUILDINGS

12 ‘‘SEC. 247. (a) RECOMMENDATION FOR FEDERAL

13 BUILDINGS.—

14 ‘‘(1) IN GENERAL.—Not later than 90 days

15 after the date of the enactment of the Cardiac Ar16 rest Survival Act of 1999, the Secretary shall assist

17 in providing for an improvement in the survival

18 rates of individuals who experience cardiac arrest in

19 Federal buildings by publishing in the Federal Reg20 ister for public comment the recommendations of the

21 Secretary with respect to placing automatic external

22 defibrillators in such buildings. The Secretary shall

23 in addition assist Federal agencies in implementing

24 programs for such placement.

25 ‘‘(2) AGENCY ASSESSMENTS.—Not later than

26 180 days after the date on which the recommenda-
5

S 1488 RFH1S

1 tions are published under paragraph (1), the head of

2 each Federal agency that occupies a Federal build3 ing that meets the criteria described in subsection

4 (a)(1) shall submit to the Secretary an assessment

5 of the ability of each such agency to meet the goals

6 described in subsection (c).

7 ‘‘(b) ADDITIONAL RECOMMENDATIONS.—The Sec8 retary shall publish, as part of the recommendations re9 ferred to in subsection (a), recommendations with respect

10 to the placement of automatic external defibrillators in

11 buildings and facilities, or other appropriate venues, fre12 quented by the public (other than the buildings referred

13 to in subsection (a)). Such recommendations shall only be

14 for information purposes for States and localities to con15 sider in determining policy regarding the use or placement

16 of such defibrillators in recommended buildings, facilities

17 or venues.

18 ‘‘(c) CONSIDERATION OF CERTAIN GOALS FOR SUR19 VIVAL RATES.—In carrying out this section, the Secretary

20 shall consider the goals established by national public21 health organizations for improving the survival rates of

22 individuals who experience cardiac arrest in nonhospital

23 settings, including goals for minimizing the time elapsing

24 between the onset of cardiac arrest and the initial medical

25 response.
6

S 1488 RFH1S

1 ‘‘(d) CERTAIN PROCEDURES.—The matters ad2 dressed by the Secretary in the recommendations under

3 subsections (a) and (b) shall include the following:

4 ‘‘(1) Procedures for implementing appropriate

5 nationally recognized training courses in performing

6 cardiopulmonary resuscitation and the use of auto7 matic external defibrillators.

8 ‘‘(2) Procedures for proper maintenance and

9 testing of such devices, according to the guidelines

10 of the manufacturer of the devices.

11 ‘‘(3) Procedures for ensuring direct involvement

12 of a licensed medical professional and coordination

13 with local emergency medical services in the over14 sight of training and notification of incidents of the

15 use of the devices.

16 ‘‘(4) Procedures for ensuring notification of an

17 agent of the local emergency medical system dis18 patch center of the location and type of device.

19 ‘‘(e) CERTAIN CRITERIA.—In making recommenda20 tions under subsections (a) and (b), the Secretary shall

21 determine the following:

22 ‘‘(1) Criteria for selecting the public buildings,

23 facilities and other venues in which automatic exter24 nal defibrillators should be placed, taking into

25 account—
7

S 1488 RFH1S

1 ‘‘(A) the typical number of employees and

2 visitors in the buildings, facilities or venues;

3 ‘‘(B) the extent of the need for security

4 measures regarding the buildings, facilities or

5 venues;

6 ‘‘(C) buildings, facilities or other venues,

7 or portions thereof, in which there are special

8 circumstances such as high electrical voltage or

9 extreme heat or cold; and

10 ‘‘(D) such other factors as the Secretary

11 determines to be appropriate.

12 ‘‘(2) Criteria regarding the maintenance of such

13 devices (consistent with the labeling for the devices).

14 ‘‘(3) Criteria for coordinating the use of the de15 vices in public buildings, facilities or other venues

16 with providers of emergency medical services for the

17 geographic areas in which the buildings, facilities or

18 venues are located.’’.

19 SEC. 4. IMMUNITY FROM CIVIL LIABILITY FOR EMERGENCY

20 USE OF AUTOMATED EXTERNAL

21 DEFIBRILLATORS.

22 Part B of title II of the Public Health Service Act,

23 as amended by section 3 of this Act, is amended by adding

24 at the end the following section:
8

S 1488 RFH1S

1 ‘‘LIABILITY REGARDING EMERGENCY USE OF AUTOMATED

2 EXTERNAL DEFIBRILLATORS

3 ‘‘SEC. 248. (a) PERSONS USING AEDS.—Any person

4 who provides emergency medical care through the use of

5 an automated external defibrillator is immune from civil

6 liability for any personal injury or wrongful death result7 ing from the provision of such care, except as provided

8 in subsection (c).

9 ‘‘(b) OTHER PERSONS INVOLVED WITH AEDS; SPE10 CIAL RULES FOR ACQUIRERS.—

11 ‘‘(1) IN GENERAL.—With respect to a personal

12 injury or wrongful death to which subsection (a) ap13 plies, in addition to the person who provided emer14 gency medical care through the use of the automated

15 external defibrillator, the person described in para16 graph (2) is with respect to the device immune from

17 civil liability for the personal injury or wrongful

18 death in accordance with such paragraph, except as

19 provided in subsection (c).

20 ‘‘(2) PERSON DESCRIBED.—A person described

21 in this paragraph is the person who acquired the de22 vice for use at a nonmedical facility (in this para23 graph referred to as the ‘acquirer’). Such person

24 shall be immune from liability as provided for in

25 paragraph (1) if the following conditions are met:
9

S 1488 RFH1S

1 ‘‘(A) The condition that the acquirer noti2 fied local emergency response personnel of the

3 most recent placement of the device within a

4 reasonable period of time after the device was

5 placed.

6 ‘‘(B) The condition that, as of the date on

7 which the emergency occurred, the device had

8 been maintained and tested in accordance with

9 the guidelines established for the device by the

10 manufacturer of the device.

11 ‘‘(C) In any case in which the person who

12 provided the emergency medical care through

13 the use of the device was an employee or agent

14 of the acquirer, and the employee or agent was

15 within the class of persons the acquirer ex16 pected would use the device in the event of a

17 relevant emergency, the condition that the em18 ployee or agent received reasonable instruction

19 in the use of such devices through a course ap20 proved by the Secretary or by the chief public

21 health officer of any of the States.

22 ‘‘(c) INAPPLICABILITY OF IMMUNITY.—Immunity

23 under subsections (a) and (b) does not apply to a person

24 if—
10

S 1488 RFH1S

1 ‘‘(1) the person engaged in gross negligence or

2 willful or wanton misconduct in the circumstances

3 described in such subsections that apply to the per4 son with respect to automated external defibrillators;

5 or

6 ‘‘(2) the person was a licensed or certified med7 ical professional who was using the automated exter8 nal defibrillator while acting within the scope of

9 their license or certification, and within the scope of

10 their employment as a medical professional.

11 ‘‘(d) RULES OF CONSTRUCTION.—

12 ‘‘(1) IN GENERAL.—The following applies with

13 respect to this section:

14 ‘‘(A) This section is not applicable in any

15 State that (before, on, or after the date of the

16 enactment of the Cardiac Arrest Survival Act of

17 1999) provides through statute or regulations

18 any degree of immunity for any class of persons

19 for civil liability for personal injury or wrongful

20 death arising from the provision of emergency

21 medical care through the use of an automated

22 external defibrillator.

23 ‘‘(B) This section does not waive any pro24 tection from liability for Federal officers or em25 ployees under—
11

S 1488 RFH1S

1 ‘‘(i) section 224; or

2 ‘‘(ii) sections 1346(b), 2672 and 2679

3 of title 28, United States Code, or under

4 alternative benefits provided by the United

5 States where the availability of such bene6 fits precludes a remedy under section

7 1346(b) of title 28.

8 ‘‘(C) This section does not require that an

9 automated external defibrillator be placed at

10 any building or other location.

11 ‘‘(2) CIVIL ACTIONS UNDER FEDERAL LAW.—

12 ‘‘(A) IN GENERAL.—The applicability of

13 subsections (a) through (c) includes applica14 bility to any action for civil liability described in

15 subsection (a) that arises under Federal law.

16 ‘‘(B) FEDERAL AREAS ADOPTING STATE

17 LAW.—If a geographic area is under Federal

18 jurisdiction and is located within a State but

19 out of the jurisdiction of the State, and if, pur20 suant to Federal law, the law of the State ap21 plies in such area regarding matters for which

22 there is no applicable Federal law, then an ac23 tion for civil liability described in subsection (a)

24 that in such area arises under the law of the

25 State is subject to subsections (a) through (c)
12

S 1488 RFH1S

1 in lieu of any related State law that would

2 apply in such area in the absence of this sub3 paragraph.’’.

Passed the Senate November 19, 1999.

Attest: GARY SISCO,

Secretary.